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Despite widespread use of the bacille Calmette-Guérin (BCG) vaccine, tuberculosis (TB) remains a leading cause of global mortality from a single infectious agent (Mycobacterium tuberculosis or Mtb). Here, over two independent Mtb challenge studies, we demonstrate that subcutaneous vaccination of rhesus macaques (RMs) with rhesus cytomegalovirus vectors encoding Mtb antigen inserts (hereafter referred to as RhCMV/TB)--which elicit and maintain highly effector-differentiated, circulating and tissue-resident Mtb-specific CD4[sup.+] and CD8[sup.+] memory T cell responses--can reduce the overall (pulmonary and extrapulmonary) extent of Mtb infection and disease by 68%, as compared to that in unvaccinated controls, after intrabronchial challenge with the Erdman strain of Mtb at [similar]1 year after the first vaccination. Fourteen of 34 RhCMV/TB-vaccinated RMs (41%) across both studies showed no TB disease by computed tomography scans or at necropsy after challenge (as compared to 0 of 17 unvaccinated controls), and ten of these RMs were Mtb-culture-negative for all tissues, an exceptional long-term vaccine effect in the RM challenge model with the Erdman strain of Mtb. These results suggest that complete vaccine-mediated immune control of highly pathogenic Mtb is possible if immune effector responses can intercept Mtb infection at its earliest stages., Author(s): Scott G Hansen [1]; Daniel E Zak [2]; Guangwu Xu [1]; Julia C Ford [1]; Emily E Marshall [1]; Daniel Malouli [1]; Roxanne M Gilbride [1]; Colette M Hughes [...]

Chronic-phase HIV and simian immunodeficiency virus (SIV) replication is reduced by as much as 10,000-fold in elite controllers (ECs) compared with typical progressors (TPs), but sufficient viral replication persists in EC tissues to allow viral sequence evolution and induce excess immune activation. Here we show that productive SIV infection in rhesus monkey ECs, but not TPs, is markedly restricted to [CD4.sup.+] follicular helper T ([T.sub.FH]) cells, suggesting that these EC monkeys' highly effective SIV-specific [CD8.sup.+] T cells can effectively clear productive SIV infection from extrafollicular sites, but their relative exclusion from B cell follicles prevents their elimination of productively infected [T.sub.FH] cells. [CD8.sup.+] lymphocyte depletion in EC monkeys resulted in a dramatic re-distribution of productive SIV infection to non-[T.sub.FH] cells, with restriction of productive infection to [T.sub.FH] cells resuming upon [CD8.sup.+] T cell recovery. Thus, B cell follicles constitute 'sanctuaries' for persistent SIV replication in the presence of potent anti-viral [CD8.sup.+] T cell responses, potentially complicating efforts to cure HIV infection with therapeutic vaccination or T cell immunotherapy., HIV and its nonhuman-primate counterpart, SIV, use both specific genetic mechanisms and extraordinary genetic malleability and functional plasticity to either evade or escape innate and adaptive immunity (1,2). Indeed, the [...]

Live attenuated simian immunodeficiency virus (SIV) vaccines (LAVs) remain the most efficacious of all vaccines in nonhuman primate models of HIV and AIDS, yet the basis of their robust protection remains poorly understood. Here we show that the degree of LAV-mediated protection against intravenous wild-type SIVmac239 challenge strongly correlates with the magnitude and function of SIV-specific, effector-differentiated T cells in the lymph node but not with the responses of such T cells in the blood or with other cellular, humoral and innate immune parameters. We found that maintenance of protective T cell responses is associated with persistent LAV replication in the lymph node, which occurs almost exclusively in follicular helper T cells. Thus, effective LAVs maintain lymphoid tissue-based, effector-differentiated, SIV-specific T cells that intercept and suppress early wild-type SIV amplification and, if present in sufficient frequencies, can completely control and perhaps clear infection, an observation that provides a rationale for the development of safe, persistent vectors that can elicit and maintain such responses., It has been two decades since the first report that LAV administration can completely protect rhesus macaques from subsequent challenge with highly pathogenic, wild-type SIV(1), a degree of efficacy that [...]